Le nkinga ejwayelekile esifundeni sikaParkinson idinga indlela yokucabangela
I-Levodopa iyimithi ejwayelekile yegolide ye-Parkinson's disease, okusho ukuthi yizidakamizwa ezizuzisa kakhulu futhi eziyinhloko. Isebenza ngokuguqulwa ibe yi-dopamine, esiza umuntu ukuhambisa nokulawula imisipha yawo.
Ngeshwa nokho, ngenxa yabantu abaningi, njengoba i-Parkinson iqhubeka, i- levodopa ayisebenzi futhi ekuqedeni noma ekulawuleni izimpawu zomuntu.
Lokhu kungenxa yokuthi, ngokuhamba kwesikhathi, i-levodopa iqala ukuguga ngokuphindaphindiwe, iholele imithi "isenzo sokuvala."
Okufanelekile, uma uthatha amanani wemithi efana ne-levodopa ohlelweni oluvamile, akufanele uqaphele umehluko omkhulu ezimpawu zakho phakathi kwamanani. Ngamanye amazwi, izimpawu zakho kufanele zihlale zihlala njalo ngokuhamba kwesikhathi, kungakhathaliseki ukuthi ugcine ukuthatha imithi yakho.
Kodwa-ke, uma isenzakalo esivela ku-in-off siqala ngesifo sikaParkinson, uzozizwa kangcono ("ku-") njengoba umthamo omusha wemithi yakho uqala ukusebenza, futhi kubi nakakhulu ("phuma") ngaphambi kokuthi uthole enye umthamo . Ekugcineni, ubude bokuthi "ku-" buba bufushane futhi ukugqoka "kuvaliwe" kwenzeka maduzane (ngokushesha kakhulu kwenye i-levodopa).
Yeka ukuthi amazwi ka-Parkinson's On-Off Phenomenon aphi
Abanye ochwepheshe baye bachaza "isikhathi" ngokufana nokushintsha ukukhanya, futhi isikhathi "sokuvala" njengoba izibani zihamba.
Esimweni esithi "on", umuntu onesifo sikaParkinson angase abe nomuzwa onamandla futhi akwazi ukuhamba kalula. Kodwa-ke, esimeni "esivaliwe," umuntu angase abe oqinile, aphuze, futhi angase akwazi ukuhamba nhlobo emaminithini ambalwa. Umuntu angase abe nobunzima bokukhuluma, futhi ungamqaphela ukuthi ukhuluma ngamazwi abo.
Njengoba ungacabanga, isimo "esikude" singase singakhululekile.
Ukuphatha i-Phenomenon yoku-Off-off ku-Parkinson
Kwabanye abantu abanesifo sikaPasinson, ukuguqulwa kwe-"on-off" kuyinto engacabangeki. Bayazi ukuthi imiphumela ye-levodopa izogqamuka ngemva kwamahora amathathu, ngakho-ke ingahlela ngokufanele.
Kwabanye abantu, ngeshwa, ukushintsha kwe-"on-off" akunakulinganiswa, futhi lokhu, yiqiniso, isimo esiyingozi kakhulu. Akekho owaziyo ukuthi kungani ukuguquguquka kungenakulinganiswa kwezinye izimo.
Lokho kusho ukuthi kunezinketho ezimbalwa ezitholakalayo uma wena noma isiqalo sakho esithandekayo sibhekene nesimo sokusuka.
Kwabanye abantu, ukushintsha kwezimoto kubonakala sengathi kuphendula izinhlobo ezilawulwayo zokukhishwa kwe-levodopa (ebizwa ngeSinemet CR). Kodwa-ke, i-levodopa elawulwa ngokulawulwayo ayisebenzi kahle kuwo wonke umuntu futhi ngeshwa, ingabangela ezinye izimpawu zibe zimbi nakakhulu.
Esikhundleni sokushintsha uhlobo oluhlukile lwe-levodopa, udokotela wakho anganciphisa isikhala phakathi kwama-levodopa amanani ngamaminithi angaba ngu-30 kuya kwangu-60 (ikakhulukazi ePhakinson ephakeme).
Ngaphandle kwalokho, udokotela wakho angancoma ukuthi ungeze imithi. Ama-agonists e-Dopamine, uma enezelwa ku-levodopa, anganciphisa ubude besikhathi osichithayo "ngaphandle," kepha abe nomngcipheko wemiphumela emibi kakhulu njengemiboniso ebonakalayo kanye nokuziphatha okuphoqelekile.
I-COMT inhibitors njengo-Comtan (i-entacapone) ingaqhubeka futhi ikhulise umphumela we-levodopa kodwa ingangandisa imiphumela emibi kuyo.
Okokugcina, uma ungeziwe ku-levodopa, ama-inhibitors we-MAO-B angasiza (nanobe nemiphumela emibi). Ama-inhibitors e-MAO-B asebenza ngokuvimbela i-enzyme evame ukuvimbela i-dopamine ebuchosheni.
Ngesifo sePasinson esithuthukile, ukukhulelwa kwe-gel emathunjini emathunjini kungasiza, kanti iziqephu ezinzima zalesi sigqoko, umuthi ongenayo injini okuthiwa u-Apokyn (apomorphine hydrochloride injection) ungase ube usizo.
Izwi elivela
Isimo esivimbayo siyinkinga enhle ekwelapheni kwesifo sikaParkinson, kanti ngenkathi abanye abantu bengase baqaphele ekuqaleni kokuqala kwe-levodopa, abaningi bayayibona eminyakeni engaba mihlanu kuya kwemihlanu.
Nakuba kunezindlela ezihlukahlukene zokulwa nalesi simo, ukubheja kwakho okuhle ukuxoxa ngazo zonke izinketho zakho nodokotela wakho. Izidingo zakho ngabanye zingase zifaneke kangcono kwelinye isu noma imithi ngokumelene nomunye- okusebenza kahle kakhulu ukuthi ungabi ngcono kunomunye umuntu.
> Imithombo:
> Fasano A et al. I-Intrajejunal levodopa ukukhushulwa esibhedlela sePacinson esiphezulu: imiphumela yesikhathi eside ezimpawu zezimoto nezingezona izimoto nomthelela kumgangatho wokuphila wesiguli kanye nomnakekeli. Ukubuyekezwa kweYurophu ngeSayensi Yezokwelapha Nezokwelapha. 2012 Jan; 16 (1): 79-89.
> Martinez-Martin P et al. I-EuroInf: isifundo sezinto ezihlolisisa kakhulu ze-apomorphine kanye ne-levodopa ukumiswa kwesifo sikaParkinson. Izinkinga zokuhamba. 2015 Ngo-Apr; 30 (4): 510-6.
> Pahwa R, uLyons KE. Ukugqoka okuhlobene ne-Levodopa kulesi sifo sikaParkinson: ukuhlonza nokuphathwa. I-Curr Med Res Opin . 2009 Apr; 25 (4): 841-9.
> Stocchi F, Jenner P, Obeso JA. Ngabe i-levodopa yezimoto ezishintshashintshayo kuqala zivelaphi esigabeni sikaParkinson? Eur Neurol . 2010; 63 (5): 257-66.
> Tarsy D. (2017). Ukushintsha kwezimoto kanye ne-dyskinesia kulesi sifo sikaParkinson. I-Hurtig HI, ed. Kusesikhathini. Waltham, MA: UpToDate Inc.